Medicare continually seeks to expand access to certain basic health care services, particularly for beneficiaries located in remote areas of the country.
This week’s updates include identifying "No Documentation" medical necessity denials for claims flagged for Recovery Auditor review; Shared System Enhancement 2015 Analysis and Design HUOPCUT hospice period and Health Maintenance Organization processing; and more!
Q: If we're not using condition code W2 but we're billing on the type of bill (TOB) 121 after we received a denial, are we paid less than if the W2 would have been used?
The government may finally have to comply with its congressionally mandated deadlines for reviewing claims at the Administrative Law Judge level after a federal appeals court this week reversed a lower court’s dismissal of a lawsuit brought by hospitals.
Q: Does the concurrence of the attending physician, that is required for condition code 44, need to be recorded by the attending physician, or can another practitioner write the concurrence
Q: Did something change with the observation services composite APC in 2016? The director of patient financial services says we no longer receive payment for it.
